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Middleware and the Clinical Hematology Laboratory


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Think Differently About the CBC!

Slide 14

February 2009

We then went back and reviewed our CBC data from our chemotherapy unit.  Our findings: 55% of the specimens were auto-verifying as compared to 80% for the rest of the practice, i.e. we were prolonging turnaround time.  Interestingly, the platelet and neutrophil counts were never significantly changed. And think about it:  we were replacing a likely accurate automated absolute neutrophil number based on the counting of thousands of cells with an inherently less accurate manual differential neutrophil percentage based on a one hundred cell count!  We also found that the so-called value of the manual differential count was that we identified left-shifted cells, red cell changes, some white cell abnormalities, and sometimes known or persistent circulating malignant cells.  Although these findings would certainly be very important in a screening CBC, in this particular setting the clinician already knew that information and just wanted to know what the platelet and neutrophil counts were.  The additional information was really of no value to the clinician in how they were looking at these particular patients at this point in time.

Think Differently About the CBC!


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